Aim. This study was designed to evaluate the immediate and long-term results of the Protocol of complex rehabilitation of 15 Kubanskij nauchnyj medicinskij vestnik 2018; 25 (5) children with bilateral through-cleft lip and palate (BTCLP) developed by the Department of pediatric dentistry, orthodontics and maxillofacial surgery of KSMU.

Materials and methods. There was conducted the evaluation of the immediate and long-term results of the complex treatment of 25 patients with BTCLP aged 0 to 18 years according to the Protocol developed by the Department of pediatric dentistry, orthodontics and maxillofacial surgery of KSMU.

Results. There was carried out a detailed analysis of the results of the application of the function-forming plate (FFP) in patients with BTCLP aged 0 to 1 year. The results of the models measurement in dynamics showed a significant growth and development of the upper jaw, the approximation of the shape and size of the upper alveolar arc to the norm, reducing the distance between its fragments to the minimum. There was established that long-term gradual orthodontic treatment provides conditions for physiological growth and development of the facial skeleton and for the formation of physiological occlusion in children with BTCLP. The usage of gentle methods of uranoplasty reduces the risk of dentoalveolar anomalies in children with BTCLP. The complex of therapeutic measures and terms of surgical intervention should be planned individually. The elimination of the defects of the alveolar process of the upper jaw by the method of autoosteoplasty is a necessary step in the complex rehabilitation of children with BTCLP during the periods of changing and forming permanent dentition. The planning of the stage of prosthetics of patients with BTCLP is individual and involves the creation of conditions for fullfledged functions of chewing, swallowing and speech, and it is recommended to carry it out with the help of modern aesthetic constructions that ensure the preservation of the results of the complex, including orthodontic, treatment.

Conclusion. The analysis of the photographs of the face, TRG, CT and jaws diagnostic models obtained during the treatment of children and adolescents with congenital cleft lip and palate confirms the high morphofunctional and aesthetic result of the application of the developed at the Department of pediatric dentistry, orthodontics and maxillofacial surgery of KSMU Protocol of comprehensive rehabilitation of children with BTCLP. 

Aim. The purpose of the study is to evaluate the influence of treatment of partial adentia by means of the dental implantation over the changes in antioxidant-prooxidant balance of oral liquid.

Materials and methods. The study was performed on 40 testees divided into 2 groups: the control group (conditionally healthy people) and the test group (patients with adentia of 1-4 teeth). During the initial examination all the testees underwent the sampling of oral liquid. The oral liquid of patients was sampled at three stages of treatment: at the suture release after the dental implantation, at the installation of the healing abutment and at the installation of orthopedic constructions. The concentration of the products of oxidative modifications of biomolecules was determined in oral liquid as well as the state of the system of antioxidant protection.

Results. As a result of a study, it was revealed that the antioxidant activity decreased by 20,7% against the background of the increase in intensity of oxidative processes in oral liquid of patients with partial adentia by 1,8 times. During the treatment it was revealed that the tendency of the gradual increase in general antioxidant potential to the control indices and the decrease in oxidative stress in oral liquid took place. The activity of superoxide dismutase and catalase in oral liquid of patients of the 2nd group sampled at the initial examination was higher than the control indices by 71,6% and 53,4% respectively. At the second stage of the treatment the activity of superoxide dismutase remained increased by 59,1% while the catalase activity decreased by 2,4 times up to the indices 1,6 times lower than the control indices. At this stage it may be noted that the catalase insufficiency is relative which can lead to the increased concentration of hydrogen peroxide against the background of the increased activity of superoxide dismutase. At the 3rd and the 4th stages of the treatment the catalase activity increased by 25,9% in comparison with the indices of the previous stage of the study while the activity of superoxide dismutase decreased to the control indices. The correlation of changes in enzymatic activity of antioxidant protection was close to one.

Conclusion. The imbalance of antioxidant-prooxidant system at early stages of treatment may provoke the complications development that’s why the attention must be paid to the perspectives of possible antioxidant correction. In general, the results of the study proved the absence of negative influence of the material used in the dental implant on metabolic systems of oral liquid. 

Aim. This study was designed for the morphological assessment of the state of tooth pulp tissues after simulated acute 29 Kubanskij nauchnyj medicinskij vestnik 2018; 25 (5) trauma under the influence of the developed dental treatment pad and three analogues in the treatment of deep caries and acute focal pulpitis.

Materials and methods. In the course of the experiment the study was conducted on white laboratory rats. The cavities on the molar chewing surface of the upper jaw were formed by spherical burs. The experimentally formed lesions of the surface layer of the pulp were treated using the developed dental preparation and three analogues. Laboratory animals were withdrawn from the experiment on days 3, 7 and 30. Animal teeth were put in a 10% neutral formalin solution, decalcified for 3 days and then put into a mounting medium. The slices obtained had a thickness of 5-15 μm.

Results. In the course of the experimental study we detected the activation of reactive and compensatory processes in the tooth pulp tissue with the preservation of its viability by using the developed dental therapeutic preparation and the Biodentin as a comparison preparation on the 30th day of the experiment. Histologically, these changes were expressed in an increase in the level of metabolic processes and in the activation of cellular elements of the tooth pulp tissue on the 30th day of the experiment.

Conclusion. As a result of an experimental study of the developed dental therapeutic preparation for the treatment of deep caries and acute focal pulpitis, there was established a specific and multifunctional property in preventing and prophylaxis of the inflammation development and enhancing the protective properties of the pulp tissue under the influence of this preparation.

Morphological evaluation of the application of the developed dental treatment pad showed a rapid arrest of the inflammatory response of the pulp tissue within 30 days and the normalization of the main components of the tooth pulp.

Developed during the conducted experimental research dental therapeutic preparation confirmed its stated properties, in particular, anti-inflammatory, antiseptic, analgesic, moreover, it is not inferior in its properties to the drugs presented in the course of the experimental study. 

Aim. This study was conducted to develop the optimal methodological approaches to early diagnosis and comprehensive treatment of type 1 diabetes mellitus in children by creating an estimation algorithm of the bone system metabolism based on the results of the studies of calcium phosphorus metabolism, calcium-regulating hormones and bone mineral density.

Materials and methods. There was carried out a general clinical, laboratory, X-ray examination of 114 children with type 1 diabetes mellitus aged 7 to 12 years with an endocrinopathy experience from eight months to ten years. The obtained data were compared with the results of the examination of 35 “healthy” and “practically healthy” children of this age group. The densitometric measurement of the bone tissue mineral density in the lumbar spine was performed by the densitometer "Lunar iDXA" with the automatic calculation of the Z-test. Orthopantomography of the jaw bones was carried out by a digital orthopantomograph "ORTHOPHOS XG 3 DS" with the subsequent calculation of the Fuchs index and the X-ray index. Laboratory diagnosis of serum indicators included calcium study (total, ionized), inorganic phosphorus, alkaline phosphatase, calcitonin, osteocalcin, parathormone, 25- Hydroxyvitamin D. Indices of the bone resorption were evaluated by the level of a product of degradation of helical protein collagen type I C-terminal telopeptides (CTx, Beta-Cross laps) in blood serum.

Results. At the early stages of development of type 1 diabetes mellitus the speed of bone tissue remodeling increases with increased bone formation. At the late stages of development of endocrine pathology the processes of bone remodeling are slowed down with the predominance of bone resorption processes over bone formation processes as well as a significant decrease in bone mineral density (Z-score <-1SD) with the predominance of criteria "within the expected age norms" and "low mineral density in relation to the average age norm" in the bone tissue structure. A statistically significant decrease in bone mineral density in children with a history of type 1 diabetes mellitus for more than five years is indicative of absolute insulin deficiency of pancreatic β cells as well as an early debut of endocrinopathy during the growth and development of bone tissue, triggering the formation of osteopenic syndrome.

Conclusion. The introduction of the algorithm for evaluating bone tissue metabolism based on modern high-tech laboratory radiology methods for diagnosing the state of musculoskeletal system in practical public health will make it possible to identify the pathological changes at early stages, when the implementation of integrated therapeutic and prophylactic measures will have the greatest impact and improve the quality of life of children suffering from type 1 diabetes mellitus. 

Aim. This study was conducted to assess the awareness of dentists about the questions of pharmacokinetics and pharmacodynamics of nonsteroidal anti-inflammatory drugs as well as to study the features of their use for the relief of pain syndrome in dental practice.

Materials and methods. By means of the questionnaires were studied 107 dentists working in dental clinics and dental departments of General hospitals, especially their use of the nonsteroidal anti-inflammatory drugs for pain relief.

Results. It was determined that 85% of doctors use non-selective and moderately selective cyclooxygenase inhibitors (COX), 15%-prefer Cox-2 inhibitor with the pronounced selectivity for pain relief. The highest number of correct answers was given by a group of doctors with work experience from 5 to 10 years (40.3%), the lowest – by doctors with work experience more than 20 years, respectively 40.3% and 36.1% of the total number of doctors from the studied groups.

Conclusion. There was noted that it is necessary to pay attention to the peculiarities of pain relief for the improvement of dentists’ work as well as to involve clinical pharmacologists for these purposes. 

Aim. This research was conducted to study the electron microscopic microstructure of the surface of the filling material «Restavrin» coated with the «Easy Glaze» sealant and without it before and after bacterial adhesion by scanning electron microscopy.

Materials and methods. There was studied the microrelief of the plates preliminarily made from a polymeric nano-hybrid filling material («Restavrin», Technodent, Russia) with and without the sealant «Easy Glaze» and without it both in the initial state and after being placed in a medium with microorganisms. The material for microbiological examination (the contents of the gingival sulcus) was taken from 23 patients with a diagnosis of «dentine caries» by sterile turundas. The test material was directly placed near the patient's chair in a Petri dish with enriched blood agar. Nutrient media with inoculations were delivered to the laboratory for further research. After selecting the necessary area for scanning at the same magnification (×200) (the size of the scanned section is 50x68 μm2) at a certain vertical interval, 6-8 horizontal lines for scanning were selected.

Results. Scanning electron microscopy at the end of the 45-day experiment showed that used S.oralis and S.mutans strains (strains isolated from dental patients’ contents of the gingival joint) have a pronounced ability to adhere what indirectly confirms the formation of glucans by them and, accordingly, their cariogenicity. The destructive effect of oral streptococci (S.mutans + S.oralis) on the surface of the filling materials «Restavrin» and «Restavrin» + sealant «Easy Glaze» was experimentally confirmed that clearly manifests itself after 45 days of joining streptococci and filling materials. It should be noted that the restorative material «Restavrin» under the sealant «Easy Glaze» remained nearly intact during the 45-day in vitro experiment.

Conclusion. We consider it advisable to recommend the compulsory covering of the restoration with a sealant because it serves as a kind of barrier protecting the filling material from the effect of oral streptococci. Accordingly, this procedure extends the life of the filling and also ensures the preservation of the aesthetic and mechanical properties of the composite restorations. 

Aim. In the course of this study we carried out the analysis of clinical course features and assessment of microbiological structure of the wound surface in patients with face and neck phlegmons. The etiologic cause of the disease may be hemolytic streptococcus, different types of staphylococcus, mixed flora and anaerobic bacteria.

Materials and methods. All patients required urgent surgical intervention: wide opening, drainage of cellular spaces with the subsequent irrigation with antiseptic solutions with the application of a combination of wound coverings "Aquacel Ag + Hydrofiber dressing", "Aquacel Ag Foam Hydrofiber dressing" and "Granuflex" (ConvaTec, the USA) with proper antibacterial therapy.

Results. Comparison of clinical observations (favorable course of inflammatory process) and obtained microbiological assessment (quicker decrease of microbial content in the wound) confirms validity, high efficiency of wound covering application and clear advantage in comparison with traditional gauze bandages.

Conclusion. The analysis of the causes of phlegmon on the face and neck over the past 5 years has shown a significant increase in the number of patients with traumatic, tonsilogenous and odontogenic phlegmons of the face and neck. The modern high-efficient method of local treatment with the use of wound coverings combinations makes it possible to suppress the purulent-inflammatory process at the early stage, to put the secondary stitches and shorten the period of treatment of patients. 

Aim. This study was conducted to assess the outcome of the results obtained in the treatment of patients with longterm current periodontitis with individual characteristics of the cytological picture of the microenvironment of damaged periodontal tissues.

Materials and methods. The main study group included 40 patients with chronical periodontitis of the moderate degree (Mo 56, 7 years). The selection of the regenerative treatment in the main group was carried out in accordance with the preliminary express assessment of the cytological picture of the damaged periodontal tissues. The control group, whose indicators were compared with the main clinical indicators, included 43 patients with randomly selected regenerative treatment.

Results. The cell-potential surgical approach statistically induces the growth of new dentogingival junction in patients with critically small amount of morphologically altered neutrophil granulocytes and small cell forms with intense basophilic coloring (≤20%) in cytological samples in comparison with the control decreasing the amount of residual loss of teeth supporting tissues by 2 times.

Conclusion. The preliminary express assessment of the cytological picture of the microenvironment of periodontal pockets indirectly indicates the potential of the patient with periodontitis to restore the missing structures of the periodontal membrane. The choice of the surgical tactics of regenerative treatment, taking into account the characteristics of cellular behavior in cytological samples of patients with periodontitis, is advisable to use as a prognostic test to improve the final results. 

Aim. The aim of this study is to systematize the scientific knowledge and reconstructed periodontium reliability degree by means of cell-potentiated surgical treatment of patients with the chronic periodontitis.

Materials and methods. All 76 patients included in the study (aged 23 to 68 years, Mo 55.3 years) underwent a surgery for directed regeneration of periodontal tissues which was supplemented by transplantation of vascular stromal cell fraction isolated from the patient's adipose tissue (VSF AT). The evaluation of the results of the main periodontal parameters, processed by means of variation statistics in 690 periodontal defects of different topography, was carried out within 10 years.

Results. The use of the VSF AT demonstrated the advantage of the method expressed by the formation of a new timeresistant dentogingival junction with the reconstruction of the alveolar bone with a minimum amount of the marginal recession and the probing depth.

Conclusion. The percentage of positive results in the representative statistical sample was 90.3% in the main group, 75.6% in the control group within 10 years. 

Aim. The research was conducted to develop and implement the complex of diagnostic activities in patients with dysfunction of temporomandibular joints with signs of bruxism.

Materials and methods. To achieve this aim we conducted a comprehensive diagnosis of 61 patients aged 20-29 years with bruxism and temporomandibular joints dysfunction (TMJD), the patients were divided into two groups. To diagnose and analyze the results of the disease treatment in patients we used a computer analysis with visualization of changes of the osteoarticular surface and parameters of the joint gap in the TMJ. Depending on the ratio of prognostic risk criteria and the development of bruxism, we distinguished the area of low, medium and high level of risk of disease progression.

Results. Comparison of the treatment results of patients with bruxism from two groups in 12-24 months showed that patients from the second group had good treatment results. Patients of the second group underwent a complex of diagnostic activities and its data increased the treatment effectiveness. The results obtained from the treatment of patients from the first group indicate the lack of data from the standard examination of patients with bruxism.

Conclusion. The developed complex diagnostic activities in patients with bruxism in combination with dysfunction of the TMJ and occlusive attrition of teeth allow to assess not only the local status but also to determine the functional state of dentoalveolar system and the cerebral cortex which affects the amount of therapeutic activities in the patient. 

Aim. This research was conducted to study the type of clinical changes in the diseased periodontal tissues by means of using mesenchymal stem cells for treating gingival recession in the experiment.

Materials and methods. Adipose tissue in a volume of 1-2 ml was sampled from one specimen in sterile conditions in order to obtain allogeneic mesenchymal stem cells before the beginning of the experimental studies. Random-bred female white rats (60 specimens) were used as a model in the experiment. The surgical intervention was performed in the area of incisors on the upper and lower jaws of rats. All animals were divided into 5 groups (10 rats in each group) depending on the planned method of the treatment. The control group, intact rats, consisted of 10 laboratory animals with a healthy gingiva. The creation of a model of the experimental gingival recession was carried out by the mechanical V-shaped excision of periodontal tissues.

Results. The experimental studies showed the possibility of complete regeneration of the dentogingival papillae as well as periodontal tissues regeneration in the area of the experimental gingival recession during the first 28 days. Meanwhile, there is a complete absence of inflammatory signs in the 5th group (hyperemia, edema, gingival bleeding), along with their significant decrease in the 3rd and the 4th groups that confirms the pronounced therapeutic effect of mesenchymal stem cells and sterile bioplastic collagen material «Collost» (7% gel).

The conclusion. While studying the type of clinical changes in diseased periodontal tissues using mesenchymal stem cells in the treatment of gingival recession, we established the positive dynamics in the experiment. The decrease in the intensity and prevalence of gingival inflammation starts from the 14th day. On the 28th day there was noted a complete absence of inflammatory signs in the animals after injecting the transplant consisting of the cell suspension on the sterile bioplastic material Collost (7% gel). Furthermore, the significant increase in the regeneration of the gingival margin was observed on the 24th day from the moment of creating the gingival recession model. The complete regeneration of the dentogingival papillae and the absence of the gingival recession were noted on the 38th day of general observation. 

Aim. This research was designed to study the functional state of masseters in patients with hypermobility of heads of the mandible by the traditional treatment and using transcranial electrostimulation.

Materials and methods. There was conducted the examination and treatment of 80 patients with hypermobility of heads of the mandible. All patients were divided into two groups: the 1st group (n=20) received standard treatment, the second group (n=60) received traditional treatment with the inclusion of myogymnastics, massage in the temporomandibular joint area, transcranial electrostimulation, use of the apparatus of A. Sidorenko that limits the movement of the lower jaw. The control group included 10 volunteers without the pathology in the temporomandibular joint. The masseters were studied by an electromyography method before the treatment, in 1 month and in 6 months after the treatment using the computer and Miokom electromyograph. The obtained results were processed with use of the "Statistica Statsoft" program version 6.1 and "Microsoft Excel 2010".

Results. The analysis of the amplitude of bioelectric potentials of the masseters made it possible to establish that when using transcranial electrostimulation and the proposed intraoral apparatus of Sidorenko AN, limiting the amplitude of mouth opening, in 6 months after the end of the treatment in patients with hypermobility of the lower jaw the increased bioelectrical activity of the masseters in the state of relative physiological dormancy disappeared, the amplitude of their contractions (93.2%) normalized.

Conclusion. The results of the electromyographic study of temporal and masseter muscles made it possible to conclude that use of the transcranial electrostimulation and the intraoral apparatus of Sidorenko AN, limiting the movement of the lower jaw, has a positive effect on the functional state of the muscular apparatus in patients with hypermobility of the mandible heads. In the state of relative physiological dormancy the bioelectric potentials of the temporal and masseter muscles decrease, the amplitude of the bioelectric potentials while chewing and maximum compression of the jaws increases. 

Aim. This study was designed to evaluate the effectiveness of preventing the formation of a layer inhibited by oxygen or reducing its amount using various means.

Materials and methods. The study was performed at the Department of Therapeutic Dentistry of the FSBEI HE KubSMU of the Ministry of Health care of Russia and the laboratory instrument factory "Cascade", Krasnodar. The composite Filtek Ultimate (3M ESPE, USA) was used for the production of model samples by placing the composite material in clean plastic molds with a diameter of 13.5 mm, thickness of 4 mm and polymerization, the following materials were selected to prevent contact of oxygen with the surface of the composite: glycerin solution, lavsan plate, Teflon tape. For the comparison with the standard method of elimination of the layer inhibited by oxygen we used the finishing of the surface of the composite. The surface hardness of the samples of each group and subgroup was measured using the apparatus-hardness tester PMT-3 by the Vickers method. The multivariate analysis of variance (ANOVA) was conducted in Statistica software 13. The samples were stained separately with a solution of "Lipton" tea from 2015 for 3 years. The degree of pigment deposition was evaluated.

Results. The determining factor in the long-term functioning of the composite restoration is the stability of the surface layer. The results of the study showed the lowest microhardness of the samples from the group without any blockers of oxygen penetration without finishing (56HV), the highest microhardness was in samples from the group covered with Teflon tape with finishing (107HV). The probability value p<0.05 was obtained for all study groups. The results of the color change of the restoration were evaluated in the coloring medium. The assessment of changes in the coloring was carried out for 3 years. The results of staining allowed to confirm the obtained data of the study: 1) the intensity of staining of all samples increases over time, 2) the samples from the groups without glycerin coating were stained to a greater extent before the polymerization, without finishing in comparison with the samples from the groups without glycerin but with finishing, 3) the sample with glycerin coating and finishing was stained the least.

Conclusion. Thus, the results of the study allow us to recommend using the means preventing the formation of the oxygeninhibited later to improve the efficiency of the restoration of the composite and increase the duration of its functioning. Depending on the clinical situation, glycerin, lavsan plate or Teflon tape can be used as oxygen blockers.

Aim. This research was designed to conduct an associative population genetic study for the consideration of the impact of SNP C677T of the gene MTHFR in the congenital maxillofacial developmental anomalies (CMDA): congenital cleft lip (CCL), congenital cleft palate (CCP), congenital cleft lip and palate (CCLP) in the Krasnodar territory. The aim of the study is to establish the associations between SNP C677T of the gene MTHFR and the development of congenital cleft lip and/ or palate.

Materials and methods. In this research, the peculiarities of distribution of SNP C667T of the gene MTHFR in children with congenital cleft lip and/or palate (n=223) and their mothers (n=78) in comparison with the control group (n=124) were studied in the Krasnodar territory. The genetic demographic questionnaires were gathered for children with CMDA, the information about diagnosis was obtained from the medical records. The biological samples, including blood or scrapings of oral mucosa, were collected from children with the pathology and their mothers. The DNA was extracted from the samples by the standard method. The study of the peculiarities of distribution of alleles of SNP C677T of the gene MTHFR was performed by PCR-PFLP with endonuclease Hinf I or by tetra-primer ARMS-PCR method in children with CCL, CCP, CCLP, their mothers and the control group. Statistical processing of the obtained data was performed by the algorithms of the “Statistica” program.

Results. While comparing the profiles of frequencies of SNP C677T in children with CCL, CCP and CCLP with the control group, there were identified no significant differences in the frequency of this SNP and no peculiarities of genotypes distribution. There was identified a significant difference in the peculiarities of genotypes distribution with the control group (G=19,5232, d.f.=1, p<0,001) as well as united genotypes (С/C и С/T) in accordance to T/T (G=10,4657, d.f.=1; p<0,001) and united genotypes (C/T и T/T) in accordance to C/C (G=15,1896, d.f.=1, p<0,001) for the mothers of children with CCL, CCP and CCLP.

Conclusion. As a result of the study, we established the association of SNP C677T of the MTHFR gene with the development of congenital cleft lip and/or palate: mothers’ T/T genotype is associated with the increased risk of giving birth to a child with CCL, CCP and CCLP (in comparison with mothers with C/C+C/T genotype): odds ratio [OR]=16,63, 95% CI: 3,86-71,71; p=0,0003 and also for mothers with genotypes (C/T+T/T) in comparison with mothers with genotypes C/C: OR=3,22, CI:1,71-6,08; p=0,0002. The amount of risk is not significant in children with CMDA for T/T genotype. So it is possible to make a conclusion about the impact of C677T of the gene MTHFR in the development of CCL, CCP and CCLP only in mother’s genotype. 

Aim. This research was designed to conduct a morphological analysis of the purulent wound exudate in the complex treatment of patients with odontogenic phlegmon of maxillofacial area (MA) by the antioxidant “Rexod” and antihypoxant “Mafusol”.

Materials and methods. The objects of the study were 62 patients (aged 18 to 50 years) with odontogenic phlegmon who were divided into 3 groups. Group I (n=20) – the traditional treatment was supplemented by the intravenous drip injection of the antioxidant "Rexod"; group II (n=21) – the traditional treatment was combined with the intravenous injection of the antioxidant "Rexod" and antihypoxicant "Mafusol"; Group III (n=21) had the traditional treatment. The debridement of the purulent wound included a treatment with 0.06% sodium hypochlorite solution in all groups of patients in the first phase of the wound process; in the second phase the patients in all main groups were treated with the "Soderm" ointment dressings; in the comparison group were used the bandages with methyluracil ointment. In the third phase the gel "Kontraktubeks" was used to prevent the formation of rough scar tissue. There was carried out a morphological examination of smearsimprints of the wound exudate.

Results. The microscopic analysis of the cellular landscape of the exudate revealed a significant number of polynuclears which are probably the segmented neutrophilic leukocytes and typical eosinophils; the number of mononuclear cells represented by typical lymphocytes was 4 times less; a single presence of macrophages, plasmocytes, fibroblast-like and epithelioid cells. The signs of degeneration were identified in the cells of histiogenic origin.

Conclusion. As a result, there was revealed a gradual increase of overall amount of cells in the wound exudate in all study groups during the treatment, however, this process was pronounced to a greater extent in the patients of group I and II. The obtained result indicates the direct dependence of the activation of reparative processes in the wound from the applied medicines. 

Aim. To conduct a review of literature concerning current state of working and health conditions of health workers of dental speciality.

Materials and methods. To conduct a review of Russian and foreign literature of recent years from RSCI, Scopus, Web of Science, Pubmed.

Results. Dental speciality is considered to be one of the largest medical specializations. Development and implementation of innovative technologies, expansion of apparatus and medicamental treatment methods in dentistry increased the amount of harmful factors in the workplace of the specialists of this sphere.

Conclusion. Hygienic working conditions assessment and dental specialists’ workflow organization data require significant addition and personal professional risk assessment. The expansion of specification of the influence aspects of occupational hazards in the dentistry sphere will make it possible to decrease the risk of pathological processes emergence in the specialists of this sphere. 

Aim. This study was performed to identify the possible physiological and pathogenetic processes taking place in the mitochondrial matrix which create the conditions for lithogenesis of insoluble calcium phosphate salts (calcium carbonate...). Whereas, they can later be deposited in various tissues, taking into account the fact that the formation of calcium phosphate (calcium carbonate ...) in the human body occurs under normal physiological conditions (bone tissue, otolith...). It raises the urgency of the question of understanding the physiological and pathogenetic mechanisms of lithogenesis.

Materials and methods. There was carried out a meta-analysis of the functional states of mitochondria, to which we 125 Kubanskij nauchnyj medicinskij vestnik 2018; 25 (5) applied a mathematical model based on the changing direction and velocity of the conjugated thermodynamic and electrochemical parameters (pressure, volume, temperature, Gibbs potential, exergy…). Considering the schemes of the oxidative phosphorylation proposed by R.Mitchell and R.Williams, we created a model of the thermodynamic and electrochemical cycle of mitochondria which gives a deeper understanding of the principles of the mechanisms of the ongoing processes in the system mitochondrial matrix-internal membrane-intermembrane space.

Results. Based on the fundamental principle of functional interaction, there were proposed four functional states of mitochondria (M) in thermodynamic and electrochemical (TD-EC) cycle, to which was created a mathematical model that allows to systematize the processes accompanied by the accumulation of the electrochemical potential, in other words, the charge separation (ionization) in the paramembrane space. At the same time, on the one side of the inner membrane (mitochondrial intermembrane space) the positive charge predominates, and on the other side (the mitochondrial matrix) – the negative. These processes, in view of the repulsion of like charges, lead to the increase in pressure both in the mitochondrial matrix and in the intermembrane space. In this sense, the direction of the electrochemical processes, taking place in the intramembrane and intermembrane environment from the position of physical thermodynamics, is similar to the direction of the processes occurring in the compressible ionized gas (plasma).

The states of mitochondria are considered when the velocity of electrons along the respiratory chain, which is associated with a change in the thermal potential, changes in the thickness of its internal membrane. For the medium inside the matrix, which is an ultra-microheterogeneous dispersive mass, and also using the thermodynamic analogy with the ionized gas, by the thermal potential (Ǫ) we mean the product of pressure (P) per volume (V): Ǫ= PV. Based on the mathematical model of the thermodynamic behavior of the mitochondria and on the limitations imposed by the laws of physical and chemical thermodynamics, it is established that the greatest degree of thermodynamic perfection in the process of mitochondrial respiration corresponds to the state of "respiratory control" which, among the set of Functional States, is acceptable to consider the fundamental (basic, the first), in other words, F-I.

The hierarchy of the homeostatic system of mitochondria is built according to the degree and speed of energy consumption which constantly switches (fluctuates ...) because life is the consequence of a stable nonequilibrium state of the special molecules, since living systems are never in equilibrium and, due to their free Gibbs energy (G), perform a constant work against the equilibrium.

There is a physiological "balance" between the various functional states competing for the mitochondrial energy resources: 1) involuntary (Gibbs potential G>0) endergonic phosphorylation process which triggers ATP synthase and is accompanied by the cooling; and 2) spontaneous (Gibbs potential G<0) exergonic process that increases the temperature of the external medium. The pathophysiological "unbalance" of these mechanisms, in which the conditions for the formation of the watersoluble salt of calcium phosphate dihydrate-Ca (H2 PO4 )2 interchange with the poorly soluble calcium hydrogenphosphateСаHPO4 , can be a pathogenetic cause of the occurrence of common diseases (nephrolithiasis, osteochondrosis, atherosclerosis ...).

Conclusion. In the thermodynamic and electrochemical cycle of the mitochondrial system matrix-internal membraneintermembrane space, the direction and speed of physiological functional variables, which determine the presence and magnitude of the primary physiological needs, are important. In the multidimensional space of the physiological functional variables there is a gap of functionality. This is the range of parameters variations, the limits of which are distributed according to Gauss and are optimal for the habitat mode in the external environment, which is the cytoplasm in regards to the mitochondria. Going beyond the limits of the gap of functionality promotes the thermodynamic and electrochemical adaptation changes in the mitochondrial system itself which tends to return to the state of the thermodynamic "rest", while the mitochondria performs a cyclic process.

Relying on the fact that the fundamental principle of the functional expediency establishes the primacy of the maximum residence time of any living system in the defined ("normative", "permissible" ...) limits of the functionality gap, the fluctuations of which are conditioned by the changing external conditions and internal needs, we express confidence that, taking into account the limitations imposed by the laws of physical and chemical thermodynamics, the greatest degree of thermodynamic perfection of the mitochondrial breathing process in the dynamical electrochemical cycle is performed in the state of the respiratory control (F-I), which corresponds to the maximum entropy (S) and the minimum Gibbs energy (G). In the thermodynamic and electrochemical cycle may arise the conditions that include the adaptive biochemical changes that favor the accumulation of Ca2+ in the mitochondrial matrix, and thereby confirm the direct dependence of the calcium retention capacity on the speed of the respiration of mitochondria. At the same time, a significant amount of Ca2+ accumulates in the mitochondrial matrix, which, combined with the hydrophosphate, is transformed into the calcium diphosphate − Ca3 (PO4 )2 , which has an extremely low solubility in water. This may be a primordial mechanism of lithogenesis with the subsequent deposition of calcium phosphate salts in various tissues, causing the diseases at the organ level, in the pathogenesis of which the violation of energy metabolism is common!

Aim. This study was designed to perform the comparative evaluation of functioning of antioxidant system of blood in patients 137 Kubanskij nauchnyj medicinskij vestnik 2018; 25 (5) suffering from psychostimulants and opioids addiction syndrome.

Materials and methods. The study was performed using biological material of 52 patients divided into 3 groups. Patients who were considered to be conditionally healthy were included in the 1st (control) group. The 2nd group was presented by the patients suffering from opioids addiction syndrome, the 3rd group included patients suffering from psychostimulants addiction syndrome. Some parameters of the thiol metabolism and general antioxidant activity were identified in the blood plasma of patients as well as the level of products of oxidative modifications of biomolecules and the activity of enzymes of antioxidant protection in the erythrocytes.

Results. In the course of the performed studies it was revealed that the decreased antioxidant activity of the blood plasma by 28-40% was characteristic for the examined patients as well as the imbalance of enzymes of the antiradical protection of erythrocytes and the high intensity of oxidative modifications of biomolecules characterized by the increase in the thiobarbituric value by 2,4-3 times. The activity of superoxide dismutase in erythrocytes of patients of both test groups decreased by 35-43%, while the catalase activity increased by 15-21% in comparison with the relevant indices of the control group. The presence of such changes in the functioning of enzymes of the antioxidant protection can indirectly prove the presence of hypoxia in the examined patients. Besides, the increase in the content of easily-accessible thiol groups by 2,6-2,8 times and the decrease in the content of SH-groups difficult for access by 2,5-3,2 times was noted in patients suffering from the drug addiction. The reconstruction of the balance of various types of thiol groups can be associated with the confirmatory reconstruction of protein molecules induced by the oxidative modifications and combining of toxins.

Conclusion. The study in prooxidant-antioxidant status revealed the common traits in the disease pattern in patients suffering from various types of drug addiction. The received data allow us to discuss the perspectives of the criteria search for the laboratory biochemical monitoring of the patients with drug addiction and the possibilities of the antioxidant correction of metabolic disorders as a component of the complex therapy for such patients.

Aim. This research was conducted to study the possibility and effectiveness of the "Fast-track" fast recovery program application when performing simultaneous operations against the background of widespread peritonitis.

Materials and methods. In the course of the study were examined 66 patients, the ratio of woman/man was 45:21. The main group – 32 (48,5%) patients with the major disease of constricted postoperative hernia complicated by the widespread peritonitis and chronic calculous cholecystitis (a prospective analysis of surgical treatment). The comparison group – 34 (51,5%) patients with the identical pathology – the retrospective analysis of surgical treatment. The treatment of patients of the main group was supplemented with the application of the elements of the «Fast-track» program. Whereas, the treatment of patients of the comparison group was performed exclusively according to the standard scheme of the patient management with widespread peritonitis.

Results. Clinical, laboratory and instrumental data indicate the positive effect of the "Fast-track" program on the process of rehabilitation of patients in the postoperative period. There was a significant acceleration in the recovery of motorevacuation function of the intestine in patients of the main group in relation to the comparison group and a smaller number of complications in the main group in relation to the comparison group against the background of the application of this technique. As a result, the average duration of hospitalization of patients from the comparison group was 10- 5 days (average 12±2,4 days). While the average duration of hospitalization of patients from the comparison group was 17-20 days (on average 18±1,2 days).

Conclusion. The use of the "Fast-track" program in simultaneous operations does not increase the effectiveness of surgical treatment, thereby accelerating the process of rehabilitation of patients in the postoperative period. 

Aim. This study was conducted to assess the risk of atrial fibrillation and coronary heart disease development with mutation of hemostasis system genes.

Materials and methods. Genes polymorphisms of factor GII210A II (FII), G169A factor V (FV), Arg 353G1p factor VII (FVII), C677T MTHFR, 22Met (66a-g) MTRR, 675 5G / 4G PAI type 1 and 455G-A fibrinogen β (FGB) were examined in the patients of the main group and control group. The genotyping was carried out by PCR method using competing TagMan probes complementary to the polymorphic region of DNA.

Results. As a result of the research, there was identified a reliable prognostic risk of the development of coronary heart disease (CHD) and atrial fibrillation paroxysms (AFP) in patients with mutations of the VII blood coagulation factor genes, mutations in the MTHFR gene, mutations in the MTRR gene.

Conclusion. The obtained results indicate the risk of CHD and AFP development in patients with mutations of the VII gene of the clotting factor, mutation in the MTHFR gene and mutation in the MTRR gene. It may be the basis for early diagnosis, monitoring and treatment of this category of patients. 

Aim. This research was performed to study the specific immunoprophylaxis of rotavirus infection among child population in Krasnodar.

Materials and methods. There was conducted the analysis of 2386 medical records of patients who were immunized against the rotavirus infection by the pentavalent reassortant vaccine "Rotatec" for the period of 2013-2017, the assessment of the incidence of acute intestinal infections (AII) and rotavirus infection among vaccinated and unvaccinated children of the first two years of life as well as a comparative analysis of primary prophylaxis of rotavirus infection with the incidence of rotavirus infection according to data of Rospotrebnadzor for the study period.

Results. Coverage of the vaccination against rotavirus infection among children in Krasnodar for the period of 2013−2017 was 5,6 % of the target cohort which is not enough to reduce the incidence of rotavirus gastroenteritis. There was demonstrated the efficacy and safety of rotavirus vaccine. During the study period vaccinated children were 2.5 times less likely to suffer from AII. No cases of rotavirus infection were reported among the vaccinated respondents.

Conclusion. The leading role of rotavirus infection in severe forms of acute gastroenteritis in children of the first 5 years of life as well as the high efficiency of vaccine prophylaxis gives hope that vaccination against rotavirus infection will be included in the Russian national calendar of preventive vaccinations everywhere in the nearest future. 

Aim. This study was designed for the determination of the priority directions of the reduction of the population mortality of the Yamalo-Nenets autonomous district and the estimation of the place of death from certain major groups of death causes in total mortality in the Yamal-Nenets autonomous district for the period of 1993−2016.

Materials and methods. There was performed the analysis of the dynamics of death rates and the number of deaths depending on the sex, age group, locality and causes of death.

Results. The change in the sex and age structure of the population due to the natural aging and migration movements (the decrease in the proportion of the population younger than 20 years by 8.38% and the increase of the proportion of the population older than 60 years by 4.62% of the total population) had a major influence on the dynamics of the change in death rates of the population. The most significant causes of death in 2016 were: in men − cardiovascular diseases, external causes of death, neoplasms; in women − cardiovascular diseases, neoplasms, external causes of death. The primary directions of reducing the mortality of the population of the YNAO can be determined by the most significant groups of causes of death: cardiovascular diseases of the population; diseases of the digestive system; neoplasms of the digestive, respiratory and genital organs; infant mortality due to infections (with the exception of respiratory infections) and circulatory problems; deaths due to alcohol-related causes.

Conclusion. The obtained results can form the basis for management measures to reduce mortality in the Yamalo-Nenets Autonomous District.